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Introduction: Helicobacter Pylori (H. pylori) is a gram negative, spiral
gastro duodenal pathogen that infects 50% of the world population.
Although infection is acquired during childhood but disease
manifestations appear decades after the acquisition of infection and
may lead to serious consequences like gastritis, ulcers and
gastrointestinal malignancies. Presentation is variable but its association
with recurrent abdominal pain, gastroesophageal reflux, iron deficiency
anemia and asthma is still controversial. This study was aimed to review
the characteristics of H. pylori gastritis including clinical presentation,
diagnostic modalities and Sydney system classification of gastritis in
children at a private center.
Methods: It was a retrospective study conducted at pediatrics division of
a private tertiary care hospital, Dr. Suleman Al-Habib Medical Group,
Riyadh. Confirmed cases of H. pylori gastritis based on endoscopy and
histopathology were included in a total of 202 children who underwent
oesophago gastroduodenoscopy (OGD) from Jan 2009 to Jan 2014.
Clinical profile of these patients including age at presentation, gender,
socioeconomic status, clinical presentation, treatment prescribed,
endoscopic and histopathological findings was reviewed.
Results: Out of 202 patients who underwent upper gastrointestinal
endoscopy, 49 (24%) were found to have H. pylori gastritis. Mean age of
presentation was 10.5±2.53 years. Most of the patients were in the age
range of 11-16 years (52%) and only 3% were less than 5 years. Females
were 58%. Abdominal pain and heartburn were the major presentation in
84% and 28% respectively followed by vomiting and growth failure. Antral
nodularity was the commonest feature on endoscopic examination.
Reflux esophagitis was the feature in 14% (n=7). All patients had chronic
active gastritis. Atrophic gastritis was a feature in few patients while most
had non-atrophic gastritis. None of the patients showed metaplastic,
dysplastic or malignant changes. Villous atrophy was found in 10%. All
the patients were put on eradication therapy. 82% responded well to
treatment.
Conclusion: H. pylori infection is not an uncommon entity and an
important cause of gastritis in Saudi children. The similarity of features of
H. pylori in this private practice population suggests similarity in different
subsets of the Saudi population. Prospective studies are needed to clarify
risk factors in our community.
Anjum Saeed, Hamad AlJaedi, Anhar Ullah. (2016) The Clinical Presentation, Role of Diagnostic Modalities and Sydney System in Helicobacter Pylori Gastritis in Children, Pakistan Pediatric Journal, Volume 40, Issue 4.
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